Category Archives: Relapse

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The Space Between

“When we ski the trees, the trick is to focus on the spaces between, not the trees themselves.  The lines we choose are defined by our fears and our confidences, and when these are out of balance, when our fears outnumber our confidences, we lose the ability to find the spaces between the trees.  We lose our rhythm.  This goes for life, too.

My wife has anorexia.  She’s struggled with this all her life, but recently – to keep the analogy rolling – she smacked into the trees.  She’s struggling to find the spaces between.  As her partner, I’ve struggled to keep her moving through the forest.  At times, I’ve guided her into trees too dense for her to navigate.  What appears to me as an open glade of old-growth aspen, to her is a tangled mess of icy deadfall.

But I must keep my partner from becoming lost completely.  I’m responsible for her safety, and she for mine.  I can point out the spaces, but I can’t expect her to ski them as I would.

Rhythm, when skiing the trees, is as important as finding the spaces between.  The two are interlinked; one cannot exist without the other.  At speed, it’s easy to decide which way to go, which space to pass by and which to pass through.  With each turn is another decision in a rhythm that repeats itself over and over again; turn after turn, flowing from space to space.  I struggle mightily to find good lines these days.  Skiing much too slowly to find any rhythm, I’m forced to stop short – to hunt for a new space in woods that only seem to grow more dense.

Skiing the trees, there are no guarantees, no timelines: only expectations.  It’s not certain; I only expect my partner and I will find our rhythm again, and we’ll flow from space to space as easily as we once did. Momentum is everything.  We’ll gain momentum, and though it doesn’t always lead to the spaces between, stopping leaves us no choice but to stare at the trees”.

  • James Foukes, Backcountry Magazine

 

 

 

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Can you laugh about it now?

“Then she pulled at my stitches one by one and looked at my insides clicking her tongue, and said ‘this will all have to come undone’  And doesn’t that sound familiar? Doesn’t that hit too close to home? Doesn’t that make you shiver: the way things could’ve gone?

And doesn’t it feel peculiar, when everyone wants a little more?  And so that I do remember, to never go that far, could you leave me with a scar”

– Missy Higgins, Scar

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So this last week I did something very mature, facing up to some things from my past and not burying my head in the sand about them. I was in an accident when I was at university, which basically involved me stepping out right in front of a bus in the middle of the Brisbane CBD…. I don’t actually remember from about 20mins before the accident to the whole two weeks I was in hospital. I had multiple fractures (skull, jaw, ribs, shoulderblade), torn hip labrum and some pretty gnarly road rash from hitting the bitumen. Everything healed, and life moved on….but now that I’m getting older I am finding that I’m having to face up to some of the consequences of that accident, likely confounded by my long-running relationship with Ana during that time which would have affected how well my bones and body healed.

My husband – who doubles as my physio (friends with benefits haha) – has been at me for some time now to get follow up scans done on my neck and left hip just to see how they are looking and whether we need to be concerned in the long run, since I am determined to be doing Ironmans or at least running until I skid full throttle into the grave at some point, hopefully a ripe old age. My neck still bothers me and the hip catches a lot, but neither of them stop me from doing anything right now.

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Cutest little bum you ever did see

So I went and visited the sports doctor who managed my foot injury a couple of years back, and he organised the scans; today I went back to discuss the results. We work with him a lot on a professional level as well – I consider him more of a friend than a doctor and I feel like I can talk openly to him about my past. My little mini (my 9 month old son) was with me, charming everyone left right and centre. We were making small talk about who he looks like and somehow got onto talking about genetic traits….and how one side of my family is full of eating disorders and mental health problems. Then we got on to talking about the actual accident, how it happened and the forces involved so that we could discuss the pathology together. I joked “so yeah, I stepped out in front of a bus. And no, before you ask, I wasn’t drunk or suicidal….but I probably hadn’t eaten for a week so I may as well have been!” then laughed it off, because that’s what I do.

And then he asked “can you joke about it now?”.

“What – the bus accident or the anorexia?!”.

“No, the eating disorder”.

I paused. “That’s a very serious question!”, I said again attempting to laugh it off.

He waited for a serious answer.

I thought about it.

“Well, I guess you have to laugh about it, right? Or else you cry about it. It’s one or the other. Why do you ask?”.

He replied that in his experience most people never get to a point where they feel ok talking about it. I still don’t feel comfortable with it, that’s for sure. But I do know that while that part of my life is now safely fairly hidden (since we moved from Brisbane 7 years ago I strategically don’t tell anyone…it’s nice that people here don’t know that part of my life and gives me a sense of freedom from their judgement about my body), it’s also important that there are a few people who I can turn to when I’m struggling. Dr C is one of those people. Two close girlfriends; my coach; and my husband are the others. And I guess when push comes to shove, I don’t really know that laughing about it is a healthy response.

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Preparing for my Ironman comeback one year post pregnancy, two years post foot surgery.

There’s nothing funny about anorexia.  It destroyed my mind, my body; took away my childhood and leaves me with a very deep pit of anger that bubbles only millimetres away from the surface (it does not take much scratching to delve there). And yet here I am, living an amazing life, at a “healthy” weight, and considered “recovered” (whatever that means).

But the scars remain and I can tell you that the voice of Ana never goes away…even after all this time I could flick a switch and go back there in a heartbeat. I don’t want to, because I have so much more to lose these days – my husband and son deserve so much more from me and I want to be fully present to experience all the happiness they give me on a daily basis. I don’t want to allow Ana to steal my ability to be present in those moments and replace that with anxiety about the next meal, the next opportunity to burn calories, or the number on the scale.

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BUT. And there has to be a But. I don’t know what other way to cope and to move forwards than to be able to face each day, give it my best, and be able to vent by joking about Ana to my “inner circle”; precious people who I know go way beyond judging me on my body weight or my scarred past. I still have to talk about the heavy shit (for one of a better description) with my psychologist on a fairly regular basis, which inevitably results in tears, slow progress and home truths…so I guess for me this is a way of processing all that went on and attempting to repackage it in a way that is more palatable. I have other friends from treatment who I’m still in touch with, and more still from around the world who I have connected with since recovering. Many of them never talk about their ED pasts except to fellow sufferers. Some go above and beyond to hide their history from everyone, denying anything. More still are what I would consider “partially recovered”, masquerading behind a healthier BMI but almost as neurotic as they ever were about their food and exercise consumption. A rare few are strong enough to cope with recovery by flipping it on its head and going fully public about it in the hope to help others who are struggling too. I don’t feel like I am bulletproof enough to do that; there still needs to be that barrier of anonymity there for me when going about my daily life not as a “Recovered Anorexic” but just as me, who used to have an ED but doesn’t any more. Especially with my job as a health professional. And still…when I see patient of mine, friends or even strangers walking down the street so obviously going through the hell of an ED, every cell of my body wants to run straight to them, hug them and take away all the pain. But I know I’m not the right person to do it, and I would not be strong enough to resist the pull myself.

 

So on goes life.

 

I’m not sure what the correct answer is but for now, “Yes, I Can Laugh About It”. I can also cry about it. Revert back to it for hours, days or weeks at a time. Flirt with the line in the sand between “recovered” and “disordered eating patterns”. And especially, I can be pissed off about it, mainly for the family issues that still exist and trigger me off so easily (case in point: during a 5 day stay with my parents recently I managed to lose an impressive 4kg…and I wasn’t even trying). I can be ashamed of it. I can be in denial about it. I can wish it never happened.

 

But above all, I have to be stronger than it, and to rise above it, and to ultimately think that it has made me who and what I am today. And for that, I have to be thankful and at peace.

 

Onwards and Upwards,

K xo

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Pregnancy, Dual-Athlete Households and Ironmums

Yesterday marked a new low point in my Pregnancy: throwing up in the middle of the foodcourt of a very busy shopping centre. Yup, that happened. No warning and obviously no time to run to the bathroom. The running commentary in my head was quite comical, from the “Oh God this is actually happening” moment through to “thank God I actually look pregnant now, not just like some super prolific Bulimic…” (LOL). At 7 months, you’d think one would have stopped throwing up, but apparently this little bubba is a strong one on the hormonal front and having a laugh causing mum lots of embarrassment!

Top 6 female finishers at Ironman Western Australia, 2014...plus Wynne

Top 6 female finishers at Ironman Western Australia, 2014…plus Wynne

In other news this week, my new hero Beth Gerdes – Professional Ironman athlete and baby-mumma to 6 month old Wynne – whipped around the Busselton Ironman course in a PB time of 9 hours and change, clocking one of the fastest marathons of the day in under 3 hours….all while dad Luke McKenzie (also a Pro Ironman athlete) and Wynne cheered her on. I’m not going to launch into the politics of Feminism, but I will say that as a member of a dual-athlete household where I am actually the better Ironman athlete of the two of us, this made my heart swell.

I get so sick of people assuming when we go away to Ironman races that I must be the “wife” that goes to dutifully cheer on my husband. And let’s not forget that he doesn’t get out of it scott-free either – the heckling from his mates when I beat him down the finish chute of an Ironman is ridiculous. But I’m lucky enough to have a husband who is both manly enough to not let that phase him, and who is also super proud of my athletic achievements and happy to defend me – like he says, if I’m in front of him then it means I’m having a great day and that makes him happy (he’s beaten me a few times too, but on the current score card I win…..and the last one I beat him on, I had a broken foot for the marathon, so he’s not living that down for a while….!).

Anyway back to Beth and her superhuman effort. I’m not advocating that the mere mortals among us who balance a day job with training loads shoot for the goal of an Ironman PB 6 months post-partum, but this is her career and it’s her “normal”, and I am hugely proud that her partner Luke is so publicly supportive of her getting her career back on track after Wynne’s arrival. They’re not the only example in the Ironman or distance running world either – thank goodness over the last 5 years we are finally starting to see a host of female professional athletes supported by their partners returning to full time sport, with happy healthy little bubbas to cheer them on. I have been a one-woman study nerd in following their blogs through pregnancy and beyond, and have used a lot of their guidance in deciding how much exercise I am happy safely doing throughout my pregnancy, and also in setting a realistic race goal post-partum for myself (which includes an Ironman one year post-baby arrival, not 6 months – I have a business to run and as it’s my first child, and Ironman is a great love but not my source of income, I want to prioritise enjoying my time with the baby and not to feel rushed with the training). If you are interested in more from these amazing ladies, my favourites include of course Beth’s blog (California Training), and the blogs of Clara Peterson, Lauren Fleshman, and Steph Rothstein (the latter two come complete with photos of what REALLY happens to your body after baby….fascinating stuff!).

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As for my plans on returning to racing after the baby arrives, I’m finding that once again, reactions of those around me tend to reflect their own insecurities about things. My closest friends and family think it’s great and are super supportive; others are surprised and like to add a snide remark about “focusing on the baby” or “oh well, just see how you go with that” – with an added glint in their eye like they’re really trying to say ‘good luck finding the time/getting your body back to that level/you’re about to lose your whole identity because you’re becoming a “Mum”…..Of course my life is going to change, and I’m so excited about the next chapter with a new person front and centre and the added challenges that come with that. But I also want to set an example for my son or daughter that I am still an amazing, strong, independent woman and an athlete, as well as being a great Mum. Not to mention the travel experiences and awesome family atmosphere at triathlons in this country that our new addition will get to be a part of – seriously unreal!

The stunning Botanical Gardens in Queenstown, NZ.

The stunning Botanical Gardens in Queenstown, NZ.

On a deeper (ED) level, having a big Ironman race looming one year post-partum is also a protective thing for me. It’s long enough that I won’t feel rushed at all with preparation, but not too long in that it might interfere with when we try to fall pregnant with a sibling for this little one. But the biggest factor is it helps me to stay on track with eating and training once the baby is out, which is the “danger zone” of pregnancy for those of us who have had an ED from a relapse perspective. Even though I have maintained a healthy weight for 5 or so years now, I have still found the pregnancy body changes quite confronting, and have fears about the post-partum period. It’s hard to ignore the statistics on relapse rates. But I do know me, and I know that I have beaten the stats to recover after a decade of Ana; I also know how to pull my head out of a relapse phase in the earlier stages and in my case, it’s by focusing on running or triathlon (and in this case, producing breastmilk too) – which means being healthy, not skinny.

When I have a big race goal, I am focussed on being 100% healthy and strong – no nutrition short-cuts, and the focus is off weight and onto performance, which has in the past worked perfectly for me because the better you eat, the better you perform and the happier you are. I fear that if I don’t plan any big races, the focus will too easily slip back to losing all the baby weight or worse, the number on the scale….and it’s a slippery slope from there. On the flipside, I also feel as though if 100% of my focus is on the baby, then I will fall into the trap of having to be the ‘perfect’ Mum, and that’s a dangerous game to play as well – from a postnatal depression point of view.

The weekly baking for work - well fed Physios are happy Physios!

The weekly baking for work – well fed Physios are happy Physios!

As always, balance is key….. with a side of preparation, and communication: these are things that I have spent many, many hours discussing with my psychologist, husband and to a lesser extent, dietician, in the hope that I can be as prepared as possible and to minimise the overwhelmed and isolated feelings that can come with motherhood. With less than 12 weeks of baby-growing to go, I’m feeling very ready for this next exciting stage of our lives!

Happy Training xo

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FUNCTION OVER FORM. ALWAYS.

You never quite realise how much you take your mental cues from the physical body – that is, until you try to recover from an eating disorder. Or get pregnant. That glimpse of flat abs, outline of a six-pack, the toned and lean legs, tanned and glowing skin from hours in the sunshine; these things you take for granted at the time, but are all a daily reminder that you are fit, healthy and an athlete. Recovered.

Being so recovered, I thought of myself as being “above” all of that. Above needing physical clues – indeed, I didn’t even realise how much I relied on them until they went away. You do all this work on the mind during recovery, establishing yourself as a whole person being so much more meaningful than a weight on the scales or a dress size. But what I didn’t realise is that in my successful quest for recovery, I had replaced many of the anorexic cues with athlete cues – arguably, much more healthy for me, but nonetheless a crutch of sorts for self-esteem and self-worth.

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This was a deliberate strategy to a large extent on the behalf of both my psychologist and my dietician: as being particularly resistant to treatment after 10+ years of anorexia, it was eventually discovered that I work best when we replace the focus of weight with the focus of athletic performance. Function over form. As I’ve discussed in previous posts, a key component to the success of this strategy was in allowing me to continue with my athletic and University endeavours during this treatment process. My incentive was as simple as this: If I don’t fuel my body correctly, I cannot perform athletically to my potential nor academically. And for me, my self-esteem and self-worth became more hinged over time on my identity as an athlete and a smart, successful woman. I fuelled my body and mind and discovered, in doing so, that my potential was far greater than I had ever dreamed of. I found my niche in Ironman and my passion in physiotherapy and succeeded in recovery life. Together we created visions of where I wanted to be – career-wise and athletically – and honed in on what I required of my body and mind in order to achieve these goals. Ana did not fit in with those dreams. Fuelling my body for hard training sessions, recovering well for my mind to work, and achieving some sort of balance in the way of sleep and relaxation were all imperative to the puzzle working.

I realise this strategy may not work and indeed may not be necessary for some ED sufferers. It worked for me primarily because physiologically I was, while underweight, stable enough to be allowed to keep exercising, albeit at a reduced load to my previous program. I was also at a key age: old enough to be independent and choosing to be in recovery; but also still studying at University and therefore able to easily manipulate where I wished my career pathway to go from here. You could call it “lucky”; I prefer to think it was my time – I had been in several treatment programs at younger ages and none had worked. So successful was the strategy that even now, when I’m having particularly challenging Ana thoughts that last more than a few days, I am able to trace it back to either work or training not going well for me. Focus has gone away from the things I’m most passionate about and my go-to backup is Ana. It happens subconsciously, only now I am so much better at recognising it and addressing it. Function over form. Recalibrate your life, sort it out….there we go.

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The reason all of this is on my mind is that with the last 8 weeks of hell (being pregnant with the worse morning sickness ever) – there has been little training, time in the sun, intake of nutritious food, all-important sleep; even work has gone largely out the window (it’s difficult to treat patients when spontaneously vomiting). You’re growing a baby – possibly the ultimate function! – but you are so sick that it’s hard to comprehend this, and it’s also such a new identity: baby-grower. Person-manufacturer. Mum. So, day by day the Ana thoughts creep back and to make matters worse, all those lovely physical cues you didn’t even know you loved so much start slipping away – the stomach and boobs rounded, the skin grey and pale, dark circles under the eyes, muscle tone going….

But alas the solution lies in the past. Let’s get the focus back to my newest function: growing an awesome human. And yes, let’s remember that the morning sickness does not last forever. It is not Ana returning, just a transient loss of all the things that make me, me. Now that I am starting to get back outdoors, get into work, swimming and running, baking, and eating wonderful food again, sure enough the happiness grows too day by day. It might take me a while to get used to this new addition to my identity (“baby-grower”), but in time, it will come. It took a long time to see myself as an athlete, I can’t expect to click my fingers and have this happen overnight.

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Chin up, stay strong, and remember that those thoughts aren’t you…..you, my friend, are far more beautiful than that.

K xoxoxo

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Pregnancy and Eating Disorders

How do you rattle a Type-A control freak with a history of Anorexia and a love of exercise? Shower her with morning sickness and extreme fatigue, and watch her world unravel….

Challenging would be an understatement for the last couple of months of my life. My previously well-controlled little cocoon that I know as my life, with routine, structure, and an all-important sense of controlling what is happening to my body, has been dismantled for the best possible reason. But the fact that there is a little person growing inside me only manages to give me glimpses of fleeting happiness amidst the 24-7 nausea, vomiting, and extreme fatigue. I know that this will improve once the sickness eases, and I cannot wait to feel as though I’m floating on clouds with happiness about our little human growing day by day in my belly (and, well, just to be able to eat something – anything – without vomiting would be great too!).

Coffee won't be happening any time soon!

Coffee won’t be happening any time soon!

Throughout the challenge of the last couple of months it has taken all of my strength to maintain some semblance of a healthy lifestyle and body in which to house my little person. This surprised me. I am well into recovery and haven’t had a relapse for quite some time. And aside from anything else, my Psychologist has always been adamant that the best cure for an eating disorder is to get pregnant. I did question him about this one time, to which he elaborated that we of the selfless kind tend to be able to eat for someone else but rarely for ourselves. And also that suddenly we have no control over what our body is doing and so there tends to be some relief in the fact that there’s not a lot we can actually do about that for once. Then I questioned him further about after the baby comes out – when relapse rates hit a spike – and well turns out that’s another story, but we won’t go into that right now…. I do know that it took me a good 5 years after recovery to truly believe that I was ready to start a family. Of course, the fear of the weight and body changes scared me. But it was actually a much deeper fear that stopped me from wanting children: I was petrified that if I had a daughter or son, they would have Anorexia one day too. And that was something my heart just couldn’t cope with. It took a very long time of sorting through that with my psychologist before I felt more confident that I could do everything in my power to prevent that from happening: the genes I pass on I can’t change, but the environment of the child I most certainly can. And will.

I guess the hardest part for me currently is that I am acutely aware of trying to maintain the healthiest possible food intake and exercise program, and keep stress levels low, laugh a lot – all the things a little human needs to grow happily. But when every smell – from perfume to food to drinks – bothers you and every meal and snack is a massive psychological and physical event to get through, well it’s like being thrown back into the recovery ward. To make matters worse, despite my best efforts to eat enough I am losing weight, and this plays on my mind as well. I desperately want to be healthy, and yet there’s this voice that is happy about not getting “too fat, too soon”. I know I will put the weight back on and then some, and I know that losing weight in the first trimester is common when you have severe morning sickness, and I also know that the baby is happy as Larry inside despite how I’m feeling out here in the Real World. But it still bothers and confuses me and I really didn’t expect to have so many mixed emotions around this magical event.

My best management strategies have involved getting plenty of sleep, because everything seems so much more distressing when you are tired. And incidentally, so is Morning sickness (aka 24/7 sickness). I have also found it helpful to try to do some form of exercise every day. This has been a big one for me….my goal after my foot surgery was always to be able to comfortably run 5-8km when I finally got pregnant. Catch 22: my fitness is at that level, and so is my foot, but it’s managing the nausea and tiredness that’s been the hard part. Being flexible is not easy for me, but I’ve had to learn to pick my battles and get outside for a little run/walk when I feel the least nauseous. It’s good for the baby and it’s good for my head (much better than sitting on the couch moping about how I feel). I can’t swim or bike right now, because of the body positions making me more likely to be sick, so gym work and running it is. And I have to be OK with that. I can’t control everything. And that is extremely hard to say as an Ironman athlete and former Anorexic.

My heart goes out to anyone with a history of Bulimia, I can only begin to imagine how difficult the initial stages of pregnancy must be with the challenges of extreme hunger, accompanied by frequent vomiting. I have only ever been a restrictive anorexic and I am certainly finding it a monumental challenge. Not being able to keep up my normal training routine is hard enough – I love my early morning sunrises over the pool, my bike sessions with our squad or my husband, our local Roadrunners every Saturday. I miss the physical but also the mental aspects of that. And racing….I really miss racing too.

Tragedy....I haven't even been able to handle the smell of baking!

Tragedy….I haven’t even been able to handle the smell of baking!

I follow a few Ironman athletes on social media who have recently become new Mums. Two of them “accidentally” did an Ironman or two while pregnant, without realising. I regularly think of this while I’m battling through my 5km run at a very slow pace, fighting waves of nausea, and feel like I just completed an Ironman marathon – How did they not know??!!! I am baffled. But you have to laugh and realise that in the end, every body, and mind, is so different.

For now, I am focusing on daily survival as best I can. “Lucky” for me, I have had experience with battling food and weight and so I have an army of strategies to help me through this tough patch. I am looking forward to the magic as well as the challenges to come. I’ve had a lot of time to think about coping with a changing, growing belly; how to be healthy afterwards (ie not relapse); and all the amazing things that come with this process. But as I’ve just discovered, I’m sure nothing will be as it seems on the surface – so bring on the next challenge….it’s going to be an exciting 9 months and beyond.

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K xoxo

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Exercise and Recovery

I’m going to be a little controversial with this post. I’m going to suggest that for a large majority of ED sufferers, recovery would be best done while they maintain their work or school, and for athletes, their training.

Before everyone gets riled up about it, I am not talking about those so severely undernourished that they are at risk of dropping dead from a massive heart attack at any minute, or those with suicidal tendencies….clearly an inpatient program would be best for these patients (at that stage in their recovery, even if those programs for the most part keep people alive but do not really assist in long term recovery and have notoriously high relapse rates….but that’s a post for another day). I am talking about the majority of ED sufferers who are under their individual ideal weight (note I did not say “under BMI 18” – how ridiculous, what about the person with a bigger frame who is still starving but able to maintain a BMI of 21? Are they “less sick”? of course not), are still participating in work or school, and particularly those who are athletes and see that as a part of their identity. I’m talking about the people who are functioning in society, but are significantly affected day to day by their eating disorder – maybe with the accompanying depression, lack of energy and concentration, fatigue, social isolation and the other joyous side effects.

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Here’s why. Think about this: What is the biggest challenge in recovery? I would argue that one of the hardest parts about recovery is learning to lose the “ED” identity and to learn who you really are as a person. Only once that has occurred can one begin to truly move on with their lives and to want to nourish their mind and body. Only then do they have a sense of self to take care of – a reason to recover, if you will. For recovering for someone else, or to get out of Inpatient care, or for the sake of a “goal weight”, will never do it. That typically leads quickly back to a relapse and the cycle that entails.

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Inpatient care, while necessary to sustain a life on the edge, takes away all the other factors in the patient’s life that will be the foundation of their true identity as they return to health: their job, their hobbies, their social network, and for athletes, their training and usually tightknit support crew – coaches and fellow athletes. Not only does it take those things away, it actually forces the patient to focus 100% of their time and energy on the eating disorder. Their days are spent focusing on food, psychology, analysis, resting, scales, and usually the added bonus of in-house competition between patients on who is the “most sick”. Statistically, success rates aren’t good – the weight is temporarily gained, yes; but in the long term, recovery rates can be as low as 20% for patients who have had an ED for an extended time period. The statistics have not improved even after a few decades of treatment in this way. Why not?

At some point, the patient needs to learn how to function in society in a healthy way, and for this to happen there needs to be a reason for the patient to want to get better. Want being the key word here. When an athlete-patient is allowed to keep training, albeit at a reduced load, there is an all-important reason for them to put in all the hard yards day to day that go with recovering from an eating disorder. There can be clear goals and rewards: you gain X weight, you get to train X amount. You eat X foods, you get to attend X training sessions. If you don’t, you can attend but you have to sit out and watch. Sure, it’s harder to gain weight while still training. But guess what? Eating like an athlete is hard, full stop. Years on I still find it a challenge day to day. When you train hard, you have to work even harder on fuelling your “machine” (body), and the sooner a patient gets used to that process the sooner they can master it. Secondly, gaining the weight as muscle, bone density and fat via increased food and some continuation of training is much healthier and less traumatic for the patient than gaining fat alone on a resting protocol. Lastly but most importantly, there are three overwhelming psychological benefits to this approach:

1) the motivation-reward system is clear and immediate;

2) the social interaction with teammates and coaches is maintained, which is so important;

3) the patient is nurtured through the process of minimising their ED identity and replacing that empty space with their “healthy athlete identity”. {You can replace “athlete” and “training” with anything else relevant – student and school, physio and work, etc.}

The key to this process is to have a fantastic support team who can facilitate this transition. For me, it was a brilliant Sports Dietician (it was her idea to allow me to keep training – every other rehab program I had entered forced me to rest and spiral into depression), a brilliant Psychologist who specialises in treating athletes with eating disorders, a Coach who was on board with the plan, and a flexible workplace (I was still studying at University but my part-time job as a research assistant allowed me to set my own work hours, so I could go in when my energy levels were highest – early in the morning). For the most part, my dietician set out my goals for the week and my rewards – when and if I could train etc. All the while she communicated with my psychologist, who from the get-go has focussed on establishing my identity as an athlete. As he reminded me recently, I have always done best when we focus on what my body can do (as an athlete), not how it looks. All body fat % and weight measures were taken away from me, and replaced by more relevant measures like time trials and power outputs. And the only way I can get stronger, fitter, faster, and keep up with my teammates? To eat. Simple as that. I know when I skimp, I fall behind, and as a competitive person, that is motivation enough to nourish my body.

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The best part is that the system WORKS. And it’s not just a bandaid fix – it works in the long term. To this day, years on from the start of my “recovery”, I still have a crappy day at work, feel “fat” as my go-to coping mechanism, and then know that if I go and do a solid training session, by the time I walk back through that door at the end I am going to be happy with my body and what it can do for me. Nothing to do with how it looks or what it weighs. Simply what it can do. And that’s pretty cool. Add in the extra bonuses of a good training session – fresh air, endorphins, improved fitness, mental clarity, relaxation – and it’s a win-win situation.

I make it sound easy and like the obvious solution, which for me, it was (obvious, not easy!). Nothing else had worked over the decade beforehand. And certainly this system wouldn’t work for everyone either, but for athletes, I would argue that it is the best way to structure treatment. Realistically, there needs to be a change in the way we treat eating disorders in Australia as the current inpatient systems are not working in terms of long-term outcomes and relapse rates. There is no easy answer.

Food for thought anyway.

Happy training xo

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When all else fails, Bake.

Hormones rule the World…ok I get it, I GET IT!

It’s been a pretty stressful last few months, which largely stems from the fact that I am once again faced with the ever-challenging issue of learning to trust my body.

After having a miscarriage 4 months ago, my body has decided that it’s going to do its own thing, regardless of whatever I am choosing to do. Despite zero change in my food or exercise, I have been battling an influx of hormones presumably stemming from the miscarriage. My previously flat stomach is now decidedly curved and my breasts have gone from a small B cup to a large C cup. Initially I thought that this would level off over time, but it seems they are here to stay – at least for the time being.

Tiffany's-inspired Chocolate Cupcakes. I dare you not to feel uplifted!

Tiffany’s-inspired Chocolate Cupcakes. I dare you not to feel uplifted!

It’s brought all those recovery memories flooding back. The overwhelming feeling that you are drowning in a sea of change and you don’t know when the wave is going to stop pummelling your body against the floor of the ocean. It’s also a bitter pill to swallow: that I would not only lose my baby, but that I would lose control over my body as well. My doctor reassures me that it’s a good thing, that my body is trying to set itself up to become pregnant again (which is what I want more than the world). My psychologist says that I should focus on the positives, like having amazing breasts – my husband has certainly had less trouble than me focussing on this one – and that this will not last forever. But for me, it’s all been downright confusing. Just when you think you truly know your body, know what it likes, know where its set point is, have come to accept a certain size as being healthy for your frame….it all gets thrown to the wayside. I can almost hear God laughing.

Once again it has reminded me that hormones do, in fact, control the world. Or at least our sleep, mood, emotions, fat deposition, curves, weight, fatigue and ultimately, fertility…. So what to do? The only thing I know how to do: make sure I am taking the best possible care of my body and mind and trust that it will settle into itself, wherever it is supposed to be. Which means, for me, cutting out caffeine and alcohol, eating A LOT of fruit, vegetables, good quality protein, nuts, seeds, good fats, and of course steering clear of gluten (I have Coeliac disease, as an aside, which does put me at a higher risk of miscarriage along with a history of Anorexia. Oh the joys.). It also means focussing on nourishing my body with activity that brings me joy and relaxation, namely running, dance, Pilates, group rides and swim sessions with my husband. Not because I have to do a set session or hit a predetermined interval; simply because my body can and it makes me happy. That is an important distinction. It means getting at least 8 hours of good quality sleep a night, and actively trying to relax during the day – deep breaths at work, 5 minutes of meditation when I get the chance, and laughing a lot. And of course, when all else fails, it means baking – the cheapest and best therapy of all.

Death by Chocolate: Chocolate Mousse Layer Cake with Chocolate Ganache

Death by Chocolate: Chocolate Mousse Layer Cake with Chocolate Ganache

I’m not sure that I will ever be able to accept that I cannot control what is happening with my body. Ultimately, your body will change at various stages during your life, and there is very little that you can do to stop that – short of being unhealthy and falling back into eating disorders patterns, or conversely, saying “stuff it” and allowing yourself to become significantly overweight, which is not healthy either. It is well established in the research that your body has a “set point” – a range of about 5 kg, that it will defend at all odds. So just like in recovery, when you have to trust that you won’t keep gaining and gaining indefinitely; I too have to now trust that if I nourish my body and treat it well it will do what it needs to do to create the optimal environment for baby-making and health. I can’t change what that shape ends up looking like on me, but I can change how I react to it. I am faced with a choice – to reject the change and stick to everything I have known up to this point, or to embrace that I do not have control of what is happening and to learn to love my body, no matter what form it presents in. After all, I am still the same person inside.

It’s going to be a challenge, but I’m pretty good at overcoming those.
Keep on keeping on fighting the Good Fight. This one is going to be tough.

“When doubt seeps in, you got two roads, you can take either road. You can go to the left or you can go to the right and believe me, they’ll tell you failure is not an option. That is ridiculous. Failure is always an option. Failure is the most readily available option at all times, but it’s a choice. You can choose to fail or you can choose to succeed.” – Chael Sonnen

K xoxo

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Show me how Big your Brave is

Reporters love asking celebrities what they would go back and tell their younger self. They reply with some warm fuzzy blurb along the lines of “things get better” or “be more confident”. If I could go back to my younger self – probably around age 15 – I would say: grow some balls and scream for help, scream so loud that no-one can ignore you, to hell with the fear….it may just save your life”.

Finally - the media doing something proactive towards body confidence

Finally – the media doing something proactive towards body confidence

There is inevitably those fleeting moments in the eating disorder journey where the inner You is strong enough that you could probably ask for help. But these moments are so few and so far between, that the fear quickly envelops the soul and again sets you back down the path to Ana. I can still think of the few times during my decade with Ana – count them on one hand, actually – that I would have accepted help without too much of a fight. Those moments you remember, with clarity when it was just too hard to fight any more. Broken, at last. When I do think back on those few times, it still makes me feel physically violently ill to my stomach and sets my heart pounding, even all these years later. The extent of the fear of ratting Ana out is unlike anything else. To simply say the words “I need help”, comes with a plethora of assumed baggage weighing enough to drown anyone.

While eating disorders are rarely “silent” – those around you know there is something wrong – I would bet money on the fact that no one on this planet knows everything I did to myself during those years; the extent of the body abuse and the tricks that Ana played out. So while Ana may fool you into thinking “if it was that bad, someone would have intervened by now”; in reality, you and I both know that they have no idea what you are truly doing and what goes on in your mind. Looks can be incredibly deceiving.

My birthday cake. Made by me, and yes, also eaten by me (well, one piece! Baby steps)

My birthday cake. Made by me, and yes, also eaten by me (well, one piece! Baby steps)

But then the benefit of hindsight is that in all my wisdom, I can now look back with heartbreak, thinking “if only”. If only I had said to someone that I was unwell, and that I couldn’t stop myself. That I was so scared I wanted to vomit. That I thought I had control of this thing but that turns out to be the ultimate trickery. That I don’t want to fight anymore. I don’t want to “act” like Me anymore; I want to find Me. If only….

There were many people in my life that I could have asked for help. My immediate family were a huge part of my problem and chose to be incredibly ignorant about my condition, so even as a 12 year old, I knew that was not an option. But my Aunty, my best friends, my boyfriend, my coach, and later my resident mentor at college, or my doctor…..any of these people would have given heart and soul to help me – and God knows how much they all tried at various times – if only I’d let them in. It would have taken a huge amount of guts and four words to change my life: “help me, I’m ready”.

Instead, I let Ana rule the world for a decade, pretending I was in control, but knowing full well for the latter years of my illness that I was not. In a final bid for freedom – of myself, not Ana – I jumped on a plane to Canada and set myself free in the world. I was going to get better. Only just 2 weeks in, failing miserably, alone in a backpackers in Vancouver, I collapse on the stairs from a near-lethal combination of starvation and a vomiting bug. For the record, I don’t count medical help that was not given by choice but rather by dire circumstance as “asking” for help. Clearly, this was not going to be a one-woman effort. By that stage, Ana was so strong that it was going to take a lot more than that to break her down.

On returning to Australia, this time as an adult, I checked myself into help for the first time ever. It was my choice. I was scared shitless and felt so out of control of my life, but it was what it came to. It took years of mess and emotional rollercoasters and a lot of help from my friends following that to find health and most importantly, Me. But I got there.

And yet the mind wanders at times…..How would things be different, if I’d gotten help so much sooner?

“Maybe there’s a way out of the cage where you live
Maybe one of these days you can let the light in
Show me how big your brave is”

Help is scary, I know. But living alone with Ana is scarier. Just because it’s familiar, doesn’t mean it’s ok. Deep within every perfect little Anorexic is a voice that wants so desperately to stand up for You, for everything that should be yours and that you deserve just as much as everyone else in the world. Don’t let Ana fool you into thinking you don’t deserve it. Finding that inner voice and learning to use it is often the keystone to the mountain that is Recovery. It certainly was for me.

tattoo edited

Be brave. Kick and Scream. Beg for help. I know You can do it.

“Nothing’s gonna hurt you the way that words do
And they settle ‘neath your skin
Kept on the inside and no sunlight
Sometimes a shadow wins
But I wonder what would happen if you

Say what you wanna say
And let the words fall out
Honestly I wanna see you be brave….

Don’t run, stop holding your tongue
Maybe there’s a way out of the cage where you live
Maybe one of these days you can let the light in
Show me how big your brave is…

Honestly I wanna see you be brave”
– Sara Bareilles

K xoxo

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Insecurities

“Step out the front door like a ghost into the fog
Where no one notices the contrast of white on white

And in between the moon and you, angels get a better view
Of the crumbling difference between wrong and right

Well, I walk in the air between the rain
Through myself and back again
Where? I don’t know”

– Round Here, Counting Crows

Please read the following scenarios and choose the most correct answer:

1) You are an elite female triathlete with the following stats to your name: two sub-9hour Ironman finishes, <12% body fat and arguably one of the fittest bodies on the planet. When asked your weight in an interview, would you:

a. Tell the truth – your body is a weapon, your job, and a beautiful machine and you are proud of it!
b. Take off 5kgs from the true amount; you think you are ‘heavy’ with the muscle on your frame and your height.
c. Refuse to answer.

2) You are an athlete who has had an eating disorder in the past, you are now recovered but do not know your weight. You haven’t been able to run for 6 months due to injury, but have the chance to run on an Alter G treadmill that your sports doctor has arranged. In order to use it, you and your doctor will find out your weight. Do you:

a. Get on it – to hell with my weight I am desperate to run!
b. Agree to use it as long as you don’t need to find out the weight, then proceed to have a meltdown about it anyway, fearing that your doctor will think you’re the most obese athlete on the planet;
c. Gracefully decline. You are desperate to run, but the trauma of going through being weighed is just too much.

What would you do?

WA Ironman 2009

WA Ironman 2009

Impossible scenarios like this face us day in, day out, when we have the tracks of a previous ED in our scar tissue. We may be doing well for the majority of life’s intricacies, but there will always be situations like the above that will either get our blood boiling, or mentally challenge us more than is desirable (I don’t think it’s considered “normal” to have a panic attack at the thought of someone else knowing your weight….).
The first scenario makes me so furious that it sends me searching for my soapbox – in fact, I did send a huge ranting email to my good friend and doctor about the exact situation. I have been in the fortunate scenario to be on a squad alongside professional Ironman athletes for the last few years, and some of the best female triathletes on the planet to that end. Our head coach boasted more sub-9hour females on his squad than any other coach worldwide. It has been incredibly insightful and for the most part beneficial for me to be able to access their wealth of experience and knowledge and to apply that to my own racing and training.

But it doesn’t come without some serious eye-opening of the bad kind. Over the years, as you get more “well”, your triggers become so much more obvious. Racing has always been one of my biggest triggers – lining up on the start line in little more than some loud flimsy lycra is one thing; having that then photographed and marketed back to you in the eschewing weeks is truly disconcerting. No-one looks good in lycra, just putting it out there. The males who don’t have eating disorders love the race photos because they look so buff and muscly; the females – ED or otherwise – hate the photos for the same reason. I continue to race because for the most part it heals my soul. I’m good at it, and so it builds my self-esteem and creates an identity other than “anorexic”; in short, the risk-reward ratio is in the right place for me.

What I have learnt, however, is that disordered eating is rife among these professional women. They are not immune to the pressures; in fact, they feel it more than most.

Which disgusts me. Here you have 5 of the fastest, fittest, most incredible female athletes on the planet, all with bodies which would make any human proud. Their bodies are their livelihood, and to that end are serving them very well. Their self-confidence should be oozing; success is practically their middle name. And yet, they feel the need to lie about their weights, ashamed by the number on the scale.

What does that mean for the rest of us?

What message does that send?

Fast forward to scenario II, where I get this amazing opportunity to start my return to run training 3 months ahead of schedule following my foot surgery, thanks to the Alter G treadmill purchased my sports doc…..and yet I baulk. Frozen. Panic sets in. I know it means being weighed, and for someone who has just had 6 months off normal training, that is paralyzing.

But why should it be? I weigh 5kg more than the average of those 5 elite females put together – their real weight, not the one they put down on our team bio page. I am healthy, lean, fit and carry as much muscle as a good Ironman athlete should. Yes, I’m a few kgs up from my race weight, but that is OK too – because I am not race-fit right now. My body is as it should be right now, and I would like to be able to “own” that.

In the end, I guess you could call me a hypocrite. It upsets me that those women feel the need to lie about their weights, and it saddens me that that will send a very wrong message to young impressionable athletes coming through. It’s as if we are expected to achieve the impossible: to have muscle and minimal fat, and good bone density, and yet to weigh in at featherweight. Consider who is setting these expectations, and whether it is a sad modern extension of the female bullying epidemic, insisting we be perfect and able to do-it-all and yet so ruthlessly judging one another for how we all look/dress/work/live/parent…..the list goes on. I can tell you that my doctor, who is a male, didn’t give two hoots about my weight. And you rarely hear males bitching about their fellow mates, judging how they live their lives. Food for thought.

My plea is for female athletes to start “owning” their beautiful bodies. Be proud that you weigh a little more than your unfit skinny counterparts because you actually have muscle tone. Be proud of what your body can do, and how far it has come. For those of us who have climbed from the dark depths of an eating disorder, also be kind and forgiving – for your body has been through so much more than you will ever know, and every day it wakes ready to heal a little more and to help you to keep fighting the good fight.

Never forget that. Own what you are, and be proud. Starting a revolution starts with one tiny step, and you just never know who you’re inspiring by how you live your life.

insecurity blog

K xoxo

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The Dirt on Dieticians

Everything you’ve wanted to know that the internet won’t tell you.

“Experience is the father of all wisdom.
And assumption is his bitch” – Brett Sutton.

Cake. It's just cake....not the spawn of the devil.....

Cake. It’s just cake….not the spawn of the devil…..

If there’s one thing certain to strike fear into the bones of most humans, it’s someone knowing the intimate details of your daily doings – every morsel of food and fluid intake scrutinised, every measure of fitness and body fat calculated, every minute of calorie-sapping exercise tallied. And judged. Usually by an underweight and pale young woman sitting unusually upright on the other side of a cold desk (sorry for the stereotype but I know a lot of dieticians and it’s hard to argue with it!).
OK so they get a bad rap. But here’s the thing – they can be your ticket to freedom and your greatest ally. They can get you what you want, faster than you can get there on your own. They can take you to new heights of perfectionism in the body composition department and by default, they can lift your athletic performances through the roof. And lower your injury and illness count. They can help you learn to eat more normally, without necessarily putting on weight.

So what’s the catch? Like any industry, there are bad ones and good ones, and you need to get it right. A bad experience can be nothing short of traumatising, so do the work first to limit the chances of hitting a bad one.

Look for an Accredited Sports Dietician (whether you’re an athlete or not…).

In Australia to become a dietician requires a 4 year-degree. During that time they learn a lot about a lot….but don’t become specialists in any one field. They’re basically good at general nutrition and hospital nutrition. To then become an Accredited Sports Dietician they have to do an extremely difficult course which involves training in the specifics of manipulating body composition in athletes and also in dealing with eating disorders, which come with a host of specific challenges (physiologically, metabolically and emotionally). I actually know good dietician friends of mine who openly admit they won’t treat ED’s, so challenging is the task. So rule number 1 to avoid a horrible experience with a dietician is to find a good one with appropriate training, and you can minimise that risk by searching on the Sports Dieticians Australia website (or relevant body in your country).

Even better: Find a Sports Dietician who has an interest in treating Eating Disorders (note I did not say “find a dietician who obviously HAS an eating disorder….).

I’ve had several bad experiences with the stereotypical uptight-skinny-hospital-dietician in my time and while they were great at boosting my weight when I probably needed it, they weren’t great at inspiring my faith in the recovery process being all rainbows and unicorns (it’s not, but it doesn’t have to be as bad with the help of someone more useful and “real-world”). So how do you find a good one without totally blowing your cover? Well I was lucky enough to have a close friend go through the dietician process first, and I knew that she was seeing someone but not gaining any weight. I probed. She confided that she instructed the dietician that she wants to learn to eat more normally, but only under the proviso she didn’t gain any weight and didn’t have to stop exercising. And the dietician obliged. I booked in the next week.

Failing being that lucky, the internet is a good resource for searching – most good dieticians will have a bio on their website and state their treatment interests. Also check their photos if they have them and see if they have a glint in their eye, shiny hair, glowing skin, no collarbones sticking out…..the healthier they are the better off you’ll be with them.

“The thought of fronting up for the first time makes me want to vomit”, “they’re going to see straight through me!”, “I’m too fat to have an eating disorder”, “If they find out how little I eat they’ll tell my family” …..and other irrational fears.

I 100% understand all of the above fears and many more. So having been through it myself, here’s the actual facts of the matter.

Yes, they will likely see straight away that you have disordered eating of some type but they will not bring that up with you, at least not initially. They legally cannot tell anyone, unless you are under 18 and extremely, about-to-drop-dead underweight (if you are over 18 you will have a say in the matter). Anything that is said to them – exercise patterns, food intake, weight etc – is legally confidential. It’s a safe space. A good dietician probably won’t weight you, and especially won’t if you ask not to be. My dietician always took other measures like circumferences but never told me what they were, just whether they were up or down. People with dietary issues come in all shapes and sizes – seriously sick bulimics can be overweight, just like someone who’s had anorexia for a very long time can be normal weight due to metabolism dysfunction – so they will never, ever look at you and think “you’re too fat to have an eating disorder”. Ever. Promise.

If you’re seeing a private dietician, and you’re paying for it, their job is to facilitate you with your goal. Whatever that goal is.
If you go in and request to eat more and stay the same weight (so long as you’re not about to die on the spot from malnutrition, in which case a hospital dietician is actually more useful to you), they will work with you on that. When I first started seeing my dietician, I was 8kg less than I am now, my “healthy adult weight”. So, not grossly underweight, but not ideal either. I was hardly eating anything, exercising the house down, miserable…..and my metabolism was getting more thrifty by the year (making it harder to lose weight). I was over it.

What she did then single-handedly prompted my recovery, in earnest this time. Over the course of a long time, she introduced more foods and more volume, and – miraculously – I actually maintained weight, even lost it at one point. During this “trust” experiment, we also included a period of 2 weeks of zero exercise, to overcome my greatest fear – of putting on weight if I stopped training. It was the scariest thing and still makes me feel sick remembering how stressful it was. I actually lost weight, which gave me a huge confidence boost in my mind and body.

Of course, I did need to gain weight in order to be healthy. But she never pushed me, just gently supported me and taught me to trust food and my body. I maintained that weight for a further 3 years, then eventually when I was ready I allowed my weight to very slowly increase to where it sits today. And I can honestly say, now that my body has hit its set point, I can pretty much eat whatever I like and it stays within 1-2 kgs. I put this down to having such a good program to start with.

You don’t need a referral from a doctor to book in.
In Australia you can call and book with a private dietician without a referral. You do not need to tell the receptionist over the phone what you want to be treated for. The cost will vary, depending on the practitioner (generally better ones are more expensive); you can claim about half the fee back from your private health cover.
Ultimately you are paying for the service and hence their job is to meet your goals. They will discuss your goals with you and go through relevant information, give you little things to work on. They’ll send you off for a couple of weeks to work on it and then remeasure and continue. Every single day they see patients who have exercise addictions, want to improve body composition, have disordered eating, thrifty metabolisms and crazy dietary practices, and who think “they’re too fat to have an eating problem”. There’s nothing they won’t have seen.

IMAG0553

My road to recovery would have been a rollercoaster of metabolism riots and psychological warfare – as opposed to a relatively smooth upwards progress curve – had I not made the mighty step to make contact with my dietician. How do I know? Because I’d tried the other way for a decade beforehand. And it was failing miserably.

“You do not drown simply by falling into dark waters; you only drown if you stay beneath the surface” – Paolo Coelho

You can do it.

K xo